Targeted endocrine

Question 1

Diabetic foot care

Answer 1

1. wear closed toe shoes to prevent injury
2. dry feet
3. dont try to use OTC meds to treat calluses
4. use lotion for dry feet but avoid inbetween toes
5. examine feet daily
6. use thermometer to check temp of bath water. should be less then 43.3 (110f)
7. trim toenails straight across and smooth the edges with an emery board
8. shop for shoes later in the day when feet are slightly less swollen to make sure shoes fit better.

Question 2

s/s hypoglycemia

Answer 2

1. cool clammy(sticky,damp) skin
2. anxiety/nervousness/ confusion
3. tachycardia

Question 3

s/s hyperglycemia

Answer 3

1. rapid deep respirations
2. abdominal cramping
3. hypotension(from dehydration)

Question 4

what is hyperglycemic-hyperosmolar state (HHS)

Answer 4

patient is able to make enough insulin to avoid ketosis therefore their blood pH is not acidic but they cannot make enough to regulate their BS therefore it is usually above 600 mg/dL

Question 5

can you mix short acting insulins with long acting?

Answer 5

only NPH can be mixed with short acting

Question 6

what is stridors and what does it indicate

Answer 6

harsh high pitched sound upon inspiration that indicates respiratory obstruction

Question 7

what is pheochromocytoma

Answer 7

a tumor that releases catecholamines(norepi). You should avoid palapating the abdomen of these patients to avoid hypertensive crisis

Question 8

s/s hypocalcemia

Answer 8

1. hyperactive reflexs (low action potential threshold)
2. paresthesias
3. weak, thready pulse
4. increased gastric motility

Question 9

s/s DKA

Answer 9

1. rapid deep respiration(kussmaul)
2. BS above 300
3. weight loss and polyuria

Question 10

cushing disease

Answer 10

1. moon face
2. weight gain/HTN (water retention)
3. hirsutism
4. thinning of the skin
5. hypokalemia/ hypocalcemia
6. hyperglycemia

Question 11

addisons disease

Answer 11

1. hypercalcemia
2. hyponatremia
3. hypokalemia

Question 12

what does the hypothalamus do

Answer 12

releases releasing or inhibiting hormones. The pituitary makes and releases the actual hormones.

Question 13

what does the posterior pituitary make

Answer 13

ADH and oxytocin they are made in the hypothalamus and transported to posterior pituitary via axons

Question 14

what does the anterior pituitary make

Answer 14

1. GH
2. TSH
3. adrenocorticotropic hormone (ACTH)
4. FSH and LH

Question 15

what does the thyroid gland need in order to make thyroxine(t4) and triiodothyronine(t3)

Answer 15

iodine

Question 16

what do the islets of langerhan do

Answer 16

they have beta cells which produce insulin and amylin. Amylin balances the effects of insulin by 1.slowing gastric emptying 2. inhibits secretion of glucagon 3.enhances satiety

Question 17

what are the parts of the adrenal gland

Answer 17

the outer part is called the cortex and the inner part is the medulla. The adrenals are attached superior to the kidneys.

Question 18

what does the adrenal gland make

Answer 18

the cortex
1.cortisol
2.aldosterone
3.androgens
4.estrogen
The medualla
1.epi and norepi

Question 19

thyroid hormone replacement teaching (propylthiouracil)

Answer 19

1. take on empty stomach

2. aluminum and calcium supplements can reduce effectiveness (think antacids)

Question 20

HbA1c

Answer 20

1. below 7% is normal
2. shows blood glucose levels over a 120 day period
3. no need to fast before test

Question 21

what is the adrenocorticotropic hormone (ACTH) test.

Answer 21

it measures the cortisol response to ACTH. If it is a bad response or absent then client has primary adrenal insufficiency.

Question 22

Pheochromocytoma test

Answer 22

a catecholamine secreting tumor found in the abdominal region.(adrenals).
-To test for this you would do a 24 hour urine collection to detect catecholamine and other substances.

Question 23

how is cushing syndrome diagnosed

Answer 23

checking urine and serum cortisol levels which would be high

Question 24

what does alcohol do to blood sugar

Answer 24

-it prevents the liver from producting glucose (hypoglycemic event). Therefore diabetics should consume carbs while drinking alcohol

Question 25

some adverse effects of steroids

Answer 25

1. osteoporosis (suppresses bone formation and increases bone resorption)
2. Iatrogenic syndrome
   - moon face, potbelly, buffalo hump
3. increase risk for infection
   - decreases lymphocytes
4. cloudy/blurry vision (cataracts)
5. fluid retention->weight gain

Question 26

Vanillylmandelic acid test

Answer 26

1. vanillylmandelic acid is an end stage metabolite of catecholamines (epi and norepi)
2. clients do not need to fast before the test
3. 24 hour urine collection should start AFTER discarding morning urine sample
4. avoid aspirin during the testing period
5. avoid coffee for 3 days prior to test